A 30yearold woman was referred to our institution for apicoectomies of the mandibular left canine and both the lateral incisors. It is classically described as a condition occurring almost exclusively in middle. Clinical, radiographic, biochemical and histological. It is an asymptomatic lesion and needs no treatment. This is the first report of the florid form of cemento osseous dysplasia in. Pulp testing is an important tool in diagnosing periapical cementoosseous dysplasia, and limited.
Differentiating early stage florid osseous dysplasia from. A 50yearold woman with osseous cementoosseous dysplasia odcod and osteomyelitis. Frequencies of the variables were described according to. Patients do not have laboratory or radiologic evidence of bone disease in.
Lesions form symmetrically in the upper, lower, or both jaws, and can occasionally cause mild pain or discomfort. The may have a circumferential radiolucency, primarily surrounding the root apices of vital teeth, and over time with the maturation of the lesions, they tend to become increasingly radiopaque. Florid cemento osseous dysplasia clearly appears to be a form of bone and cemental dysplasia that is limited to jaws. It is usually a solitary fibro cemento osseous lesion. Florid osseous dysplasia fod is a very rare fibro osseous condition presenting in the jaws.
Florid cementoosseous dysplasia genetic and rare diseases nih. Florid cemento osseous dysplasia is more commonly seen in middleaged black women, although it also may occur in caucasians and asians 5,6. The following case is an example of florid osseous dysplasia cemento osseous dysplasia. Florid osseous dysplasia fod, which was first described by melrose in 1976, is a rare benign lesion. Case report open access mandibular actinomyces osteomyelitis complicating florid cemento osseous dysplasia. Florid cemento osseous dysplasia fcod has been described as a condition that typically affects middleaged black women, and usually manifests as multiple radiopaque cementumlike masses distributed throughout the jaws. Of oral and maxillofacial radiology, faculty of dentistry, hamadam university of medical science, hamadam, iran imaging sci dent.
Pdf 2 florid cemento osseous dysplasia lawal adisa. Florid cementoosseous dysplasia fcod is a rare, benign, fibroosseous, and multifocal dysplastic lesion of the jaw that consists of cellular fibrous connective tissue with bone and cementumlike tissue. This lesion is most commonly found in middleaged black women, although it may also occur in. Cooccurence of florid cementoosseous dysplasia and simple. It appears to be a widespread form of periapical cemental dysplasia. Florid cemento osseous dysplasia 57 did not seem to be related to a simple bone cyst. N2 in 1986, a 60yearold african american woman visited the marquette university school of dentistry with a complaint of a vague, dull pain in her lower left quadrant. If you have problems viewing pdf files, download the latest version of adobe reader. The process may be totally asymptomatic and, in such. Nov 14, 2018 florid cemento osseous dysplasia fcod is a condition that occurs in the jaw bone, especially close to where the teeth are formed. Any aras of the jaws, but mainly in posterior mandible. In some cases, a familial trend can be observed 710.
Cementoosseous dysplasia cod is a benign condition of the jaws that may arise from the fibroblasts of the periodontal ligaments. Apart from neoplastic processes, chronic disfiguring and destructive diseases of the mandible are. The term florid cemento osseous dysplasia fcod refers to a group of fibro osseous cemental exuberant lesions with multiquadrant involvement. Clinically, the florid cementoosseous dysplasia is asymptomatic.
There is a reported incidence of less than 2% in the indian population. The three types are periapical cemental dysplasia common in those of african descent, focal cementoosseous dysplasia caucasians, and florid cementoosseous dysplasia african descent. Florid cementoosseous dysplasia 347 introduction the term florid cementoosseous dysplasia fcod refers to a group of fibro osseous cemental exuberant lesions with multiquadrant involvement 1. We report a case of florid cemento osseous dysplasia of the maxilla.
Florid cementoosseous dysplasia may be familial with an autosomal dominant inheritance pattern, but there are only a few examples in the literature in which the familial pattern has been confirmed 1,3. Several root canals were completed by her dentist 4 years ago. Fibro osseous lesions classifications, pathophysiology. Cemento osseous dysplasias are usually classified, depending on their extent and radiographic appearances, into three main groups. All three types are asymptomatic, and the patient is usually unaware that any changes have occurred until a radiographic examination causes the clinician to. Extensive sclerotic masses of florid cementoosseous. Florid cementoosseous dysplasia has been described as a condition that characteristically affects the jaws of middleaged black women. Cooccurence of florid cemento osseous dysplasia and simple bone cyst. Cod occurs in the toothbearing areas of the jaws and is probably the most common fibro osseous lesion encountered in clinical practice. Introduction cemento ossifying fibroma is a benign fibro osseous maxillary tumor belonging to the same category as fibrous dysplasia and cementossifying dysplasia 1. Florid cementoosseous dysplasia is a subtype of fibrousosseous lesion that commonly appears in the jaws of middleaged black women. The word florid was introduced to describe the wide spread, extensive manifestations of the disease in the jaws.
Florid osseous dysplasia with superimposed mandibular. Cemento osseous dysplasia is a fairly common lesion of the jaws originating from the elements of the periodontal ligament. This matrix displays varying degrees of mineralization in the form of woven bone or of cementumlike round acellular intensely basophilic structures. Florid cementoosseous dysplasia in a young indian woman. The current who classification 2005 recommends use of the term florid osseous. For this authors, periapical cemento osseous dysplasia or focal cemento osseous dysplasia are two different terms for the same reactive lesion. Florid cemento osseous dysplasia fcod is a well recognized fibro osseous disease of the jaws commonly seen in the middle aged african women, although it may occur in the caucasians and asians. A correct diagnosis of periapical cementoosseous dysplasia can be. Clinical, radiographic, and histological findings of florid. The purpose of this paper is to report three cases diagnosed as fcod with their clinical, radiographic and histological findings. The patient was a 71yearold woman who had had a painless swelling in the left maxillary gingiva for 2 years.
Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. The term cemento osseous dysplasia is a histopathological term, yet the diagnosis can be made by clinical and radiographic findings1. It is found more commonly in middleaged black females and also in caucasians and asians. Florid osseous dysplasia definition of florid osseous. Cemento osseous dysplasia cod is a benign condition of the jaws that may arise from the fibroblasts of the periodontal ligaments. This condition has been interpreted as a dysplastic lesion or developmental anomaly arising in toothbearing areas. Cemento osseous dysplasia is probably the most common fibro osseous lesion encountered in clinical practice. Cbct scans were retrospectively selected from a database of individuals who attended an oral medicine service. Cases with a confirmed diagnosis of periapical, focal, or florid cod were included. Cemento osseous dysplasia is a nonneoplastic process usually confined to the tooth bearing areas of jaws or edentulous alveolar process. In severe cases, focal expansion may occur due to infection. We present a rare case of florid cementoosseous dysplasia fcod occurring in a 27yearold indian woman.
Jun 27, 20 florid osseous dysplasia fod is the most dramatic and rare variant of the cemento osseous lesions in which the normal cancellous bone is replaced by dense, acellular cemento osseous tissue in a background of fibrous connective tissue. Periapical cementoosseous dysplasia registered dental. Other cemento osseous dysplasias defined as lesions which share some of the features of periapical cemental dysplasia andor florid cemento osseous dysplasia, but do not have their characteristic clinicopathological patterns of presentation. Material and methods case records of fcod and osteomyelitis over a 3 years period were retrieved, reassessed for confirmation of. Florid cementoosseous dysplasia fcod is a condition that occurs in the jaw bone, especially close to where the teeth are formed. Findings of florid cementoosseous dysplasia journal of oral. A 30yearold woman was referred to our institution for apicoectomies of the. Florid osseous dysplasia with superimposed mandibular osteomyelitis, skeletal radiology, 2014, pp. The term florid osseous dysplasia was coined in 1976 by melrose et al. Fcod refers to a set of radiolucentradiopaque periapical and interradicular lesions involving the mandible bilaterally and sometimes the maxilla. Florid cementoosseous dysplasia radiology reference. Fibro osseous lesions of the jaws include fibrous dysplasia, ossifying fibroma, and cemento osseous dysplasia cod. These lesions are most commonly seen in middleaged.
Report of 2 cases article pdf available in journal of clinical and experimental dentistry 1011 november 2018 with 98 reads how we measure reads. Since a radiographic examination by her dentist showed radiopacity in the left side of the maxilla, she was referred to the department of dentistry and oral surgery. Familial florid cementoosseous dysplasiaa case report. It appears to be a widespread form of periapical cemental dysplasia pcd. Clinical symptoms may occur due to secondary infection of exposed masses or may be due to mucosal irritation under prostheses. Florid cementosseous dysplasia of maxilla and mandible. For language access assistance, contact the ncats public information officer. Florid cement osseous dysplasia of maxilla and mandible. Then, she received antibiotics to treat acute pain and suppuration. Periapical cementoosseous dysplasia is asymptomatic, detected radiographically and usually requires no treatment. Flcod was first comprehensively described by melrose et al. Florid cementoosseous dysplasia refers to a group of fibroosseous lesions which are exuberant, multiquadrant and arise from the toothbearing area of the jaws. Background florid cemento osseous dysplasia fcod is a benign jaw lesion originating from periodontal ligament tissues usually asymptomatic and diagnosed accidentally at routine dental radiographic examination.
Nov 30, 2014 fibroosseous lesions the term fibroosseous lesion fol is a generic designation of a group of jaw disorders characterized by the replacement of bone by a benign connective tissue matrix. A case report amir eskandarloo and faezeh yousefi dept. Fcod is a very rare condition presenting in the jaws. Cemento osseous dysplasia cod is a benign condition affecting the jaw that may arise from the fibroblasts of the periodontal ligaments. Jan 17, 2012 florid cemento osseous dysplasia fcod has been described as a condition that characteristically affects the jaws of middleaged black women. Case presentation of florid cementoosseous dysplasia with. Florid osseous dysplasia fod is the most dramatic and rare variant of the cemento osseous lesions in which the normal cancellous bone is replaced by dense, acellular cemento osseous tissue in a background of fibrous connective tissue.
Radiographically, florid cementoosseous dysplasia is characterized by multiple masses of mixed radiopaque structures. Here we present a case of 37yearold female patient, who reported for. Florid cementoosseous dysplasia fcod is a rare condition presenting in the jaws of unknown aetiology. Florid cementoosseous dysplasia fcod has been described as a condition that characteristically affects the jaws of middleaged black. The lesion can be seen opposite the mandibular left first molar in a standard occlusal radiograph of the.
All alternative names for fcod were used as search terms for two electronic databases, namely medline and. Florid cementoosseous dysplasia fcod has been described as a condition that characteristically affects the jaws of middleaged black women. Fcod is most commonly found in middleaged black women, is generally asymptomatic, and is usually detected during radiological examination. Cooccurence of florid cementoosseous dysplasia and simple bone cyst. The lesions are most frequently seen in middleaged black women and show a marked tendency for bilateral and symmetric involvement. Florid cemento osseous dysplasia was first described by melrose et al. These lesions exhibit a sclerotic appearance similar to that of other lesions on conventional radiographs.
The term florid is used because of its widespread and extensive manifestation. Florid cemento osseous dysplasia is a subtype of fibrous osseous lesion that commonly appears in the jaws of middleaged black women. Fenerty s, shaw w, verma r, syed ab, kuklani r, yang j, ali s. The etiopathogenesis of fod is unknown but could derive from the periodontal ligament, the medullar bone or both 5. The etiology and pathogenesis of this entity are still unknown. Clinically, the florid cemento osseous dysplasia is asymptomatic. Patients do not have laboratory or radiologic evidence of. Cementoosseous dysplasia definition of cementoosseous. Based on all the above information, a diagnosis of florid cemento osseous dysplasia fcod was made. Florid cementoosseous dysplasia fcod is a type of fibro osseous lesion and represents a reactive process in which normal bone is replaced by poorly cellularized cementumlike materials and cellular fibrous connective tissues. Florid cemento osseous dysplasia fcod, described by melrose et al. Most lesions do not have a hereditary basis, however a few familial cases have been documented. Florid cemento osseous dysplasia is a benign bone reactive process and represents a type of fibro osseous lesion, in which normal bone is replaced by fibrous connective tissues.
Florid cemento osseous dysplasia may be familial with an autosomal dominant inheritance pattern, but there are only a few examples in the literature in which the familial pattern has been confirmed 1,3. People with fcod develop lesions in the jaw, were spots of normal bone are replaced with a mix of connective tissue and abnormal bone. In most instances, the disease affects the mandible bilaterally and may or may not show concomitant maxillary involvement. No clear definition indicates that when the multiple lesions of pcd can be. Florid cementoosseous dysplasia fcod is a benign jaw lesion originating. A case of florid cementoosseous dysplasia of the maxilla. Fibro osseous lesions of the jaws include fibrous dysplasia, ossifying fibroma, and cemento osseous dysplasia1. Focal cementoosseous dysplasia fcod is a benign fibroosseous condition that can be seen in dentulous and edentulous patients.
Aug 23, 2019 cemento osseous dysplasia is a group of disorders known to originate from periodontal ligament tissues. Benign fibroosseous lesions of the craniofacial complex a. When lesions with radiologic and microscopic features similar to fcod extend to two or more quadrants of the jaw, the disease is termed florid cemento osseous dysplasia flcod 112120. Two oral and maxillofacial radiologists assessed the scans.
May 07, 2014 jc 1 cbct findings of periapical cementoosseous dysplasia 1. Florid cementoosseous dysplasia is one of the terms that have been designated by the world health organization as cementoosseous dysplasias of the jaws. Radiographically, fcod appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Florid cemento osseous dysplasia consists of selflimiting lesions involving alveolar processes. Florid cemento osseous dysplasia and osteomyelitis for treatment purposes, the patient underwent hemato logical exams. It is most commonly seen between the third and fourth decades of life 26, and is more frequent in women than in. Till today, nearly 2% cases have been reported in the indians according to current literature 2. The human skeleton undergoes full renewal every 1 to 4 years in children and cemnto to 10 years in adults. To describe the effects of cemento osseous dysplasia cod on anatomical structures. Failure of dental implants in cemento osseous dysplasia. Jc 1 cbct findings of periapical cementoosseous dysplasia. Conebeam computed tomography analysis of cementoosseous. Florid cementoosseous dysplasia clearly appears to be a form of bone and cemental dysplasia that is limited to jaws. Cemento osseous dysplasias are categorized into three types on basis of the clinical and radiographic features.
Pdf to explore the demographic characteristics and clinical features among patients with osseous cementoosseous dysplasia odcod of the jaws and. This paper reports a case of a 15 year clinical and radiographic follow up of florid cemento osseous dysplasia. Panoramic a and periapical b radiographs show a mostly radiopaque odcod lesion accompanied by lamellar periosteal formation of new bone along the buccal surface of the mandible. The etiology of this lesion of the jaw is unknown,, but it appears to represent reactive or dysplastic processes originating from elements of the periodontal ligaments. Clinical, radiographic, and histological findings of. Florid cementoosseous dysplasia complicated by chronic.
Florid cemento osseous dysplasia clearly appears to be a form of bone and cemental dysplasia that is limited to the jaws. The three types are periapical cemental dysplasia common in those of african descent, focal cemento osseous dysplasia caucasians, and florid cemento osseous. Clinical, radiographic, biochemical and histological findings. Florid cementoosseous dysplasia pubmed central pmc. This article reports the case of a 49yearold black woman who was diagnosed with florid cemento osseous dysplasia on the basis.
The use of hyperbaric oxygen therapy in actinomycotic. Florid cemento osseous dysplasia fcod is a sclerosing disease characterised by intense opaque masses with many irregular lobules and is generally observed in the jaws and the alveolar process. Cooccurence of florid cementoosseous dysplasia and. Florid cementoosseous dysplasia genetic and rare diseases. Pdf florid cemento osseous dysplasia fcod is a fibro osseous lesion that affects jaw bones of middleaged women affecting two or more quadrants of. The lesions are often found in equal numbers and size on both sides of the jaw.
Pdf orthodontic treatment and cementoosseous dysplasia. In the present case no familial aspects of the disease could be established. Mar 14, 2020 lesions classified as cemento osseous dysplasia cod largely encompass three different subgroups. Concomitant occurrence of infected cementoosseous dysplasia. Florid cemento osseous dysplasia fcod is a rare, benign lesion affecting both the jaws. A case report article pdf available in brazilian dental journal 204. A surgical therapy was selected with removal of bone. It is an exuberant variant of cemento osseous dysplasia normally seen in multiple quadrants of the jaws.
Cementoosseous dysplasia radiology reference article. Babu1, renita lorina castelino1 1department of oral and maxillofacial radiology, ab shetty memorial institute of dental sciences, nitte university, deralakatte, mangalore, karnataka, india. Misdiagnosis of florid cementoosseous dysplasia leading to. This type must be differentiated from pagets disease, chronic diffuse osteomyelitis, and gardners syndrome. Misdiagnosis of florid cementoosseous dysplasia leading. On the other hand, clinical and histological evidences show this condition has a histogenetic origin derived from the periodontal ligament 29. It is thought to be a reactive phenomenon that arises from elements within the periodontal ligament. Florid osseous dysplasia fod is the most extensive form with bony lesions involving multiple quadrants of the jaws. Florid cemento osseous dysplasia is an uncommon disease of the jaws. This lesion may be completely asymptomatic and in such cases the lesion is detected incidentally in radiographs. Florid cementoosseous dysplasia may be confused with a simple bone cyst.
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